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A fem-pop bypass, also called a femoral popliteal bypass surgery, is a surgical procedure performed for femoral artery disease when the main vein in the leg becomes blocked with a fatty substance. It involves grafting a vessel around the blockage to allow normal blood flow to the lower extremities. Surgeons use a piece of blood vessel taken from another area of the leg or a section of artificial material to reroute blood away from the narrowed vein.
The surgery treats peripheral artery disease (PAD), a condition wherein a fatty substance builds up in the femoral artery, which carries blood to the legs and feet. People with this condition may also suffer blockages in the heart and brain because fats that accumulate in the arteries can appear throughout the body. The fats harden and reduce the amount of blood flow to the area affected. If an artery in the heart or brain is affected, it could lead to heart attack or stroke.
Fem-pop bypass procedures can be done under local anesthesia or general anesthesia, meaning the patient can be awake or asleep during the operation. The surgeon makes an incision in the leg and grafts the bypass vein around the blocked artery. Blood detours through the graft to restore blood flow that carries oxygen and nutrients to the legs and feet.
Pain is usually the first sign that a fem-pop bypass is needed. Patients with a blocked femoral artery commonly limp and experience pain in the buttocks, thigh or calf when walking. The painful limp usually appears during normal exercise or while walking.
Symptoms that surgery might be needed include cold and pale feet from the decreased blood supply. The patient might experience pain while resting that eases when he moves to a sitting position. A sore or ulcer that does not heal is another symptom that may lead to complications, such as an infection or gangrene. In severe cases, amputation of the affected limb might be necessary.
A procedure that can be effective in lieu of a fem-pop bypass is called angioplasty. A hollow catheter is inserted into the blocked femoral artery and inflated with a balloon device. This expands the opening in the vein that is blocked by fatty tissue. A metal stent may be inserted in the artery to keep it clear.
Complications of surgery include the risk of a heart attack or a clot forming in the leg. Some patients experience swelling from excessive fluid in the extremities after the operation. It is also possible that blood vessels might be damaged during the grafting process of fem-pop bypass surgery.
A friend of mine trained as a surgical scrub technician and worked a lot for a vascular surgeon. She said the fem-pop procedure was one of the more common surgeries the doctor did, along with repairing abdominal aortic aneurysms (triple A's), which are serious business.
She said the fem-pop procedure usually didn't take very long, and if the patient was in reasonably good health, recovery was usually fairly quick.
The Triple A procedure, on the other hand, was always a beast, both for the surgeon and the patient. Many, many people have died from a ruptured Triple A.